Personalized medicine: Has it started yet? A reconstruction of the early history

Within the last few years the field personalized medicine entered the stage. Accompanied with great hopes and expectations it is believed that this field may have the potential to revolutionize medical and clinical care by utilizing genomics information about the individual patients themselves. In this paper, we reconstruct the early footprints of personalized medicine as reflected by information retrieved from PubMed and Google Scholar. That means we are providing a data-driven perspective of this field to estimate its current status and potential problems.

An Innovative teaching tool for students is it Appropriate?

Background: Clinical supervision takes place once the newly qualified nurse is employed in clinical practice. However, often the variety and diversity of nursing jobs can result in a hit and miss delivery of supervision training. By introducing training uniformly at undergraduate stage a more seamless transition may occur (McColgan K, Rice C. 2012).

There is an increased interest in higher education in the use of online learning resources for students. As part completion of a DNP an App. for training students in clinical supervision was developed.

Aim: The creation of a clinical supervision training App. for use in undergraduate nursing.

Objectives:
•To develop a teaching tool that is up to date, current and easily accessible to students.
•To introduce supervision training for undergraduate nursing students
•To motivate the undergraduate nursing student to identify examples from their clinical experience to encourage change and promote professional development.

Approach:
Stage 1
In 2010/11 informal inquiries with senior nurses regarding the introduction of supervision training in undergraduate nursing
Stage 2
A review of UK supervision training.
Stage 3
Template production of teaching tool.
Stage 4
Collaboration with a computer technician to transfer multimedia outputs onto an App.
Stage 5
App. piloted with lecturers (n=4) and post registration students (n=20).
Stage 6
Minor alterations made to App. design template
Stage 7
App. included in an experimental study looking at online learning versus blended learning June 2013 (n=61, n=63)

Conclusion: A collaborative approach to the development of any educational programme is essential to ensure the success of the final teaching product (McCutcheon 2013). The end result is that this App. could be:
•Made available to nurses in the UK.
•Adapted to suit other healthcare professionals and students.
•Used as a prototype for other healthcare related subjects.

McColgan K., Rice C. (2012) An online training resource for clinical supervision. Nursing Standard, 26(24) 35-39.
McCutcheon K. (2013) Development of a multi-media book for clinical supervision training in an undergraduate nursing programme. Journal of Nursing Education and Practice, 3(5) 31-38.

It's not that I don't care, I just don't care very much: confounding between attribute non-attendance and taste heterogeneity

With the growing interest in the topic of attribute non-attendance, there is now widespread use of latent class (LC) structures aimed at capturing such behaviour, across a number of different fields. Specifically, these studies rely on a confirmatory LC model, using two separate values for each coefficient, one of which is fixed to zero while the other is estimated, and then use the obtained class probabilities as an indication of the degree of attribute non-attendance. In the present paper, we argue that this approach is in fact misguided, and that the results are likely to be affected by confounding with regular taste heterogeneity. We contrast the confirmatory model with an exploratory LC structure in which the values in both classes are estimated. We also put forward a combined latent class mixed logit model (LC-MMNL) which allows jointly for attribute non-attendance and for continuous taste heterogeneity. Across three separate case studies, the exploratory LC model clearly rejects the confirmatory LC approach and suggests that rates of non-attendance may be much lower than what is suggested by the standard model, or even zero. The combined LC-MMNL model similarly produces significant improvements in model fit, along with substantial reductions in the implied rate of attribute non-attendance, in some cases even eliminating the phenomena across the sample population. Our results thus call for a reappraisal of the large body of recent work that has implied high rates of attribute non-attendance for some attributes. Finally, we also highlight a number of general issues with attribute non-attendance, in particular relating to the computation of willingness to pay measures.

Learning fluid prescription skills: why is it so challenging?

IIt is well recognised that medical students and junior doctors find fluid prescription a challenging topic. This study was designed to gain a greater understanding of the experiences that medical students face related to learning about fluid prescribing. Methods: A qualitative approach, using focus groups, was employed in this research. Final-year medical students in academic year 2011-12 at Queen's University Belfast were invited to participate during their 'Assistantship' placement in March 2012. Discussions in focus groups, consisting of between six and eight students, were recorded and transcribed verbatim. The research team, consisting of three separate investigators, conducted thematic analysis independently. A final consensus regarding emerging themes was reached by discussion within the whole research team. Medical students and junior doctors find fluid prescription a challenging topic Results: Five prominent themes emerged: 'Teaching experience: a disruptive variation'; 'Curricular disconnections'; 'The driving test: Theory-practice transformation'; 'Role modelling: which standard to aspire to?'; and finally 'Reconciling the perceived risk'. Discussion: This re search provided insights into medical students' opinions of the teaching practices and learning experiences related to fluid prescribing. The learning of prescribing skills is complex andcontextual. In the development of such skills, medical students are often exposed to conflicting educational experiences that challenge the novicelearner in making judgements on best prescribing practice. This study adds to the body of evidence that fluid prescription is a difficult topic, and has generated a number of multifaceted and strategic recommendations to potentially improve fluid prescription teaching.

'It Is Not as Easy as ABC': Examining Practitioners' Views on Using Behavioural Contracts to Encourage Young People to Accept Responsibility for their Anti-Social Behaviour

This article examines the use of acceptable behavioural contracts as a tool for engendering the voluntary acceptance of responsibility in children and young people perceived to be engaging in anti-social behaviour and low-level criminality. Based on the results of a qualitative empirical analysis with local government and social housing anti-social behaviour teams, the article explores the attitudes of practitioners to the use of this unregulated but commonly utilised intervention. Practitioners' views are contrasted with the ideals of voluntary responsibilisation upon which the contracts are supposedly based. It is argued that there is a spectrum of differing approaches among practitioners, with some using the contracts more to encourage the voluntary acceptance of responsibility, whilst others use them more coercively to hold individuals responsible for their behaviour. The implications of these differing approaches are examined.